摘要
目的 探讨应用巩膜扣带术治疗玻璃体切除术后视网膜未复位患者的手术疗效.设计回顾性病例系列.研究对象2004～2010年北京同二医院43例43眼玻璃体切除术后视网膜未复位患者.方法 所有患者采用间接检眼镜直视下冷冻裂孔、巩膜环扎或外垫压、外放液方法治疗.对硅油填充眼,先行巩膜扣带术,术后1～4周后再行硅油取出.主要指标术后视网膜复位情况、视力、眼压和并发症等.结果 43眼中,12眼为单纯行玻璃体切除或联合玻璃体腔注气术后视网膜脱离,经一次巩膜扣带术,11眼复位,1眼失败后再次行玻璃体切除硅油填充术 24眼为硅油填充眼,其中22眼行巩膜扣带术后视网膜完全复位,1～4周后行硅油取出,2眼视网膜未复位,取油时联合视网膜切开,硅油再填充,最终1眼完全复位,1眼广泛视网膜增殖,增生性玻璃体视网膜病变（PVR）形成,光感消失,眼球萎缩 7眼为硅油取出术后视网膜再脱离眼,行巩膜扣带手术后6眼视网膜完全复位,1眼再次硅油填充.随访3～72个月,经一次巩膜扣带术后视网膜复位39眼（90.7%）,最终42眼（97.7%）视网膜复位.结论 对于玻璃体切除手术失败且裂孔位于周边部的视网膜脱离患者,采用巩膜扣带术式能有效地使视网膜再复位.
Objective To evaluate the effects of scleral buckling in failure eases of vitrectomy. Design Retrospective case series. Participants 43 eyes of 43 patients with non-reduction retina ＇after vitrectomy. Methods Retinal eryocoagulation, seleral buckling and drainage of subretinal fluid were used via indirect ophthalmoscope in 43 failure eases （43 eyes） after vitrectomy. As for the eyes filled with silicon oil, the silicon oil was removed one to four weeks after scleral buckling. Main Outcome Measures The reattaehment of the detached retina, visual acuity, intraocular pressure, and complications after scleral bucking. Results 11 eyes of 12 eyes which only received vitreetomy or combined with gas intraocular tamponade before were successfully reattached after scleral buckling in the first time, the other eye received vitrectomy combined with silicon oil tamponade after seleral buckling failed. For most cases （22 eyes of 24 eyes） filled with silicon oil, the retina reattaehed after buckling surgery once, and the silicon oil was removed 1-4 weeks later. The other two cases, for which the silicon oil were removed in combination of local retinotomy and intraoeular tamponade with silicon oil again, and one eye was healed, the other eye became atrophic because of severe proliferative vitreous retinopathy. 6 eyes of 7 eyes with redetachment retina after silicon oil removing healed after the surgery, 1 eye received silicon oil tamponade again. Over all, followed up for 3-72 months, 39 eyes （90.7%） were healed with seleral buckling in the first time, 42 eyes （97.7%） were healed at the last follow-up. Conclusion Seleral buckling is an effective treatment for the failure cases of vitreetomy in which the retinal hole localized peripherally or the retinal detachment existed inferiorly.
出处
《眼科》
CAS
2010年第6期389-392,共4页
Ophthalmology in China
